Tranexamic acid dose in trauma — DIPIMC MCQ

Correct answer: E — 1 g intravenously over 10 minutes

In major traumatic haemorrhage, tranexamic acid 1 g is given intravenously over about 10 minutes as soon as possible and ideally within one hour of injury, followed by a further 1 g infusion over eight hours in hospital; early administration reduces death from bleeding. Doses of 100 mg or 250 mg are too low, 5 g is not the recommended bolus, and the oral route is inappropriate in major trauma. The benefit falls with delay, and administration after three hours from injury may be harmful. Pearl: give tranexamic acid early, alongside haemorrhage control and blood products, rather than as a substitute for them.

Reference: NICE NG39 (Major trauma); JRCALC Clinical Guidelines